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Castro Y, Leija A, Guerra ZC, Londoño T, Heydarian NM, Correa-Fernández V. Improving Spanish translations of tobacco dependence measures using cognitive interviewing. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:8-16. [PMID: 35050814 PMCID: PMC10642076 DOI: 10.1080/00952990.2021.1998514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cognitive interviewing is the practice of systematically collecting feedback about survey items from members of the priority population, with the goal of identifying and rectifying problems to increase the comprehensibility of the survey. Evidence is limited on the extent to which this method of pretesting improves survey items. OBJECTIVE The current study examined the utility of incorporating cognitive interviewing to improve the Spanish translations of two measures of tobacco dependence. METHODS Items from the Spanish versions of the Wisconsin Inventory of Smoking Dependence Motives (68 items) and Nicotine Dependence Syndrome Scale (19 items) were subjected to cognitive interviews with Spanish-speaking smokers. Problematic items were revised based on participant feedback and re-assessed in a second round of interviews (N = 23, 78.3% male; 21.7% female). RESULTS Twenty-three of the 87 items demonstrated comprehension problems, and 67 items elicited at least one problem report. Number of problems were significantly fewer pre- vs. post-revision (t [90] = 6.55, p < .001). CONCLUSIONS In combination with standard translation procedures, cognitive interviewing with the priority population appears to be a useful method for ensuring comprehensible and relevant item content.
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Affiliation(s)
- Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin
| | | | - Zully C. Guerra
- Steve Hicks School of Social Work, The University of Texas at Austin
| | - Tatiana Londoño
- Steve Hicks School of Social Work, The University of Texas at Austin
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Londoño T, Moore JR, Guerra ZC, Heydarian NM, Castro Y. The contribution of positive affect and loneliness on readiness and self-efficacy to quit smoking among Spanish-speaking Mexican American smokers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:110-119. [PMID: 34932409 PMCID: PMC10763704 DOI: 10.1080/00952990.2021.1998513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The existing research on affective and interpersonal determinants of smoking cessation largely under-represents minority smokers, such as Latinos. OBJECTIVE The current study examined associations between affective and interpersonal factors with intermediary smoking cessation variables among Mexican-American smokers (N = 290; 60% male). METHODS Measures of positive and negative affect, social support, and loneliness were each examined for associations with measures of motivational readiness to quit smoking, and smoking abstinence self-efficacy. Significant predictors were entered into models simultaneously to examine their unique associations. Covariates included gender, age, and educational attainment. RESULTS Negative affect (b = .68, SE b = .14, p < .001) and loneliness (b = .20, SE b = .09, p < .05) were independently associated with motivation. Negative affect (b = .20, SE b = .06, p < .01) and positive affect (b = .34 SE b = .07, p < .001) were independently associated with self-efficacy. In the final models, only negative affect was associated with motivation (b = .68, SE b = .17, p < .001); whereas negative (b = .17, SE b = .06, p < .01) and positive (b = . 32, SE b = .07, p < .001) affect were associated with self-efficacy. CONCLUSION Results highlight the importance of resilience factors (e.g., positive affect) among Mexican-American smokers. Cessation interventions regularly target negative affect among smokers; additional focus on positive affect in cessation interventions with this population may be warranted.
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Affiliation(s)
- Tatiana Londoño
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | - John R Moore
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | - Zully C Guerra
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | | | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
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Kim S, Hwang H. Model-based recursive partitioning of extended redundancy analysis with an application to nicotine dependence among US adults. THE BRITISH JOURNAL OF MATHEMATICAL AND STATISTICAL PSYCHOLOGY 2021; 74:567-590. [PMID: 33782960 DOI: 10.1111/bmsp.12240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Extended redundancy analysis (ERA) is used to reduce multiple sets of predictors to a smaller number of components and examine the effects of these components on a response variable. In various social and behavioural studies, auxiliary covariates (e.g., gender, ethnicity) can often lead to heterogeneous subgroups of observations, each of which involves distinctive relationships between predictor and response variables. ERA is currently unable to consider such covariate-dependent heterogeneity to examine whether the model parameters vary across subgroups differentiated by covariates. To address this issue, we combine ERA with model-based recursive partitioning in a single framework. This combined method, MOB-ERA, aims to partition observations into heterogeneous subgroups recursively based on a set of covariates while fitting a specified ERA model to data. Upon the completion of the partitioning procedure, one can easily examine the difference in the estimated ERA parameters across covariate-dependent subgroups. Moreover, it produces a tree diagram that aids in visualizing a hierarchy of partitioning covariates, as well as interpreting their interactions. In the analysis of public data concerning nicotine dependence among US adults, the method uncovered heterogeneous subgroups characterized by several sociodemographic covariates, each of which yielded different directional relationships between three predictor sets and nicotine dependence.
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Affiliation(s)
- Sunmee Kim
- University of Manitoba, Winnipeg, Manitoba, Canada
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Nollen NL, Ahluwalia JS, Sanderson Cox L, Okuyemi K, Lawrence D, Samuels L, Benowitz NL. Assessment of Racial Differences in Pharmacotherapy Efficacy for Smoking Cessation: Secondary Analysis of the EAGLES Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2032053. [PMID: 33464316 PMCID: PMC7816102 DOI: 10.1001/jamanetworkopen.2020.32053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Understanding Black vs White differences in pharmacotherapy efficacy and the underlying reasons is critically important to reducing tobacco-related health disparities. OBJECTIVE To compare pharmacotherapy efficacy and examine variables to explain Black vs White differences in smoking abstinence. DESIGN, SETTING, AND PARTICIPANTS This study is a secondary analysis of the Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) double-blind, placebo-controlled, randomized clinical trial, which took place at clinical trial centers, academic centers, and outpatient clinics in 29 states in the US. US Black and White smokers who smoked 10 or more cigarettes per day with and without psychiatric comorbidity were enrolled between November 2011 and January 2015. Data analysis was performed from July 2019 to January 2020. INTERVENTIONS Participants were randomized (1:1:1:1) in a double-blind, triple-dummy, placebo- and active-controlled (nicotine patch) trial of varenicline and bupropion for 12 weeks with follow-up through week 24. MAIN OUTCOMES AND MEASURES Biochemically verified continuous cigarette abstinence rate (CAR) from weeks 9 to 24. Baseline, postbaseline treatment, and safety characteristics were examined as variables to explain race differences in abstinence. RESULTS Of the 1065 Black smokers enrolled, 255 were randomized to receive varenicline, 259 received bupropion, 286 received nicotine replacement therapy (NRT [ie, nicotine patch]), and 265 received placebo. Among the 3044 White smokers enrolled, 778 were randomized to receive varenicline, 769 received bupropion, 738 received NRT, and 759 received placebo. Participants were predominantly female (614 Black [57.7%] and 1786 White [58.7%] women) and heavy smokers (mean [SD] cigarettes per day, 18.2 [7.9] for Black and 20.0 [7.5] for White smokers), with a mean (SD) age of 47.2 (11.2) years for Black and 46.5 (12.7) years for White participants. Treatment and race were associated with CAR for weeks 9 to 24. The CAR was 4.9% lower for Black vs White participants (odds ratio [OR], 0.53; 95% CI, 0.41-0.69; P < .001); differences were found across all treatments. Pooling psychiatric and nonpsychiatric cohorts, varenicline (OR, 2.63; 95% CI, 1.90-3.63; P < .001), bupropion (OR, 1.75; 95% CI, 1.25-2.46; P = .001), and NRT (OR, 1.52; 95% CI, 1.07-2.16; P = .02) had greater efficacy than placebo for White participants. Only varenicline (OR, 2.63; 95% CI, 1.26-5.48; P = .01) had greater efficacy than placebo for Black participants. Baseline, postbaseline, and safety characteristics differed by race, but these variables did not eliminate the association of race with CAR. Black participants had 49% reduced odds of CAR for weeks 9 to 24 compared with White participants in the adjusted model (OR, 0.51; 95% CI, 0.39-0.66; P < .001). CONCLUSIONS AND RELEVANCE Black and White smokers achieved the highest rate of abstinence while taking varenicline, suggesting that it is the best first-line therapy for these groups. However, Black smokers were less responsive to all therapies, including placebo. Understanding variables (eg, socioeconomic or biological) beyond those may lead to improved treatment outcomes for Black smokers. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01456936.
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Affiliation(s)
- Nicole L. Nollen
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Jasjit S. Ahluwalia
- Alpert Medical School, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Alpert Medical School, Department of Medicine, Brown University School of Public Health, Providence, Rhode Island
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City
| | | | | | - Neal L. Benowitz
- Department of Medicine, Bioengineering, and Therapeutic Sciences, University of California, San Francisco
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Nollen NL, Mayo MS, Sanderson Cox L, Benowitz NL, Tyndale RF, Ellerbeck EF, Scheuermann TS, Ahluwalia JS. Factors That Explain Differences in Abstinence Between Black and White Smokers: A Prospective Intervention Study. J Natl Cancer Inst 2020; 111:1078-1087. [PMID: 30657926 DOI: 10.1093/jnci/djz001] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/03/2018] [Accepted: 01/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Black-white differences in smoking abstinence are not well understood. This trial sought to confirm previously reported differences in quitting between blacks and whites and to identify factors underlying this difference. METHODS During enrollment, 224 black and 225 white low-income smokers were stratified on race and within race on age and sex to ensure balance on these factors known to impact abstinence. The intervention included varenicline for 12 weeks and six guideline-based smoking cessation counseling sessions. The primary endpoint was cotinine-verified 7-day point prevalence smoking abstinence at week 26. A priori socioeconomic, smoking, treatment process (eg, treatment utilization, side effects, withdrawal relief), psychosocial, and biological factors were assessed to investigate race differences in abstinence. Unadjusted odds ratios (OR) were used to compare abstinence between blacks and whites. Adjusted odds ratios from logistic regression models were used to examine predictors of abstinence. All statistical tests were two-sided. RESULTS Blacks were less likely to achieve abstinence at week 26 (14.3% vs 24.4%, OR = 0.51, 95% confidence interval [CI] = 0.32 to 0.83, P = .007). Utilizing best subsets logistic regression, five factors associated with race jointly predicted abstinence: home ownership (yes/no, OR = 3.03, 95% CI = 1.72 to 5.35, P < .001), study visits completed (range = 0-6, OR = 2.81, 95% CI = 1.88 to 4.20, P < .001), income (household member/$1000, OR = 1.03, 95% CI = 1.01 to 1.06, P = .02), plasma cotinine (per 1 ng/mL, OR = 0.997, 95% CI = 0.994 to 0.999, P = .002), and neighborhood problems (range = 10-30, OR = 0.88, 95% CI = 0.81 to 0.96, P = .003). CONCLUSIONS The race difference in abstinence was fully explained by lack of home ownership, lower income, greater neighborhood problems, higher baseline cotinine, and higher visit completion, which were disproportionately represented among blacks. Findings illuminate factors that make it harder for blacks in the United States to quit smoking relative to whites and provide important areas for future studies to reduce tobacco-related health disparities.
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On providing smoking cessation services in alcohol and other drug treatment settings: Results from a U.S. national survey of attitudes among recovering persons. J Subst Abuse Treat 2020; 117:108057. [PMID: 32811636 DOI: 10.1016/j.jsat.2020.108057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/20/2020] [Accepted: 06/09/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nicotine addiction through cigarette use is highly prevalent among individuals suffering from alcohol and other drug (AOD) problems and remains a prominent risk factor for morbidity, mortality, and healthcare utilization. Whereas most people agree that providing smoking cessation services (SCS) to this vulnerable population is vitally important, the timing of such service provision has been hotly debated, including whether such services should be excluded, available (but not offered), offered, or fully integrated into AOD treatment settings. Important stakeholders in this debate are those in recovery from AOD problems who, in addition to having often been AOD treatment patients themselves, frequently hold influential clinical, research or policy positions and thus can influence the likelihood of SCS provision. This study sought to understand the attitudes of this important stakeholder group in providing SCS in AOD treatment settings. METHOD We assessed a national cross-sectional sample of individuals in recovery from an AOD problem (n = 1973) on whether SCS should be: a. excluded; b. available; c. offered; or d. integrated into AOD services. We estimated associations between participants' demographic, clinical, and recovery support service use history, and SCS attitude variables, using multinomial logistic regression. RESULTS Roughly equal proportions endorsed each attitudinal position (23.5% excluded, 25% available, 24.6% offered; 26.9% integrated). Correlates of holding more positive SCS implementation attitudes were Black race; primary substance other than alcohol, greater intensity of former or recent smoking, and less mutual-help organization participation; older individuals achieving recovery between 30 and 40 years ago also had more positive attitudes toward integrating SCS. CONCLUSIONS About half of those sampled were either against SCS inclusion in AOD settings or were in favor of making it "available" only, but not in offering it or integrating it. This oppositional pattern was accentuated particularly among those with primary alcohol problem histories and those participating in mutual-help organizations. Given the universally well-known negative health effects of smoking, understanding more about the exact reasons why certain groups of recovering persons may endorse such positions is an area worthy of further investigation, as it may uncover potential barriers to SCS implementation in AOD treatment settings.
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Zyambo CM, Hendricks PS, Cropsey KL, Willig JH, Wilson CM, Gakumo CA, Ashutosh T, Westfall AO, Burkholder GA. Racial disparities and factors associated with prescription for smoking cessation medications among smokers receiving routine clinical care for HIV. AIDS Care 2020; 32:1207-1216. [PMID: 32530307 DOI: 10.1080/09540121.2020.1776821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Factors associated with prescription of smoking cessation medication (SCM), including the impact of race, have not been well described among a large population of people living with HIV (PLWH) engaged in routine clinical care. Our study investigated whether there are racial differences between African-American and White PLWH regarding SCM prescription and sought to identify other factors associated with these prescriptions at a large HIV clinic in the Southeastern United States. Among 1899 smokers, 38.8% of those prescribed SCMs were African-American and 61.2% were White. Factors associated with lower odds of SCM prescription included African-American race (AOR, 0.63 [95% CI: 0.47, 0.84]) or transferring care from another HIV provider during the study period (AOR, 0.63 [95% CI: 0.43, 0.91]). Whereas major depression (AOR, 1.54 [95% CI: 1.10, 2.15]), anxiety symptoms (AOR, 1.43 [95% CI: 1.05, 1.94]), and heavy smoking (>20 cigarettes/day) (OR, 3.50 [95% CI: 2.11, 5.98]) were associated with increased likelihood of SCM prescription. There were racial disparities in the prescription of SCM in African Americans with HIV. These findings underscore the need to increase pharmacotherapy use among African Americans to improve smoking cessation outcomes across racial groups among PLWH.
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Affiliation(s)
- Cosmas M Zyambo
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA.,Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen L Cropsey
- Department of Psychiatry, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James H Willig
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Craig M Wilson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C Ann Gakumo
- Department of Nursing, University of Massachusetts, Boston, MA, USA
| | - Tamhane Ashutosh
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew O Westfall
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Greer A Burkholder
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Young-Wolff KC, Adams SR, Tan ASL, Adams AS, Klebaner D, Campbell CI, Satre DD, Salloum RG, Carter-Harris L, Prochaska JJ. Disparities in knowledge and use of tobacco treatment among smokers in California following healthcare reform. Prev Med Rep 2019; 14:100847. [PMID: 31024786 PMCID: PMC6476812 DOI: 10.1016/j.pmedr.2019.100847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/25/2019] [Accepted: 03/14/2019] [Indexed: 11/28/2022] Open
Abstract
The Affordable Care Act (ACA) promised to narrow smoking disparities by expanding access to healthcare and mandating comprehensive coverage for tobacco treatment starting in 2014. We examined whether two years after ACA implementation disparities in receiving clinician advice to quit and smokers' knowledge and use of treatment resources remained. We conducted telephone interviews in 2016 with a stratified random sample of self-reported smokers newly enrolled in the Kaiser Permanente Northern California's (KPNC) integrated healthcare delivery system in 2014 (N = 491; 50% female; 53% non-white; 6% Spanish language). We used Poisson regression with robust standard errors to test whether sociodemographics, insurance type, comorbidities, smoking status in 2016 (former, light/nondaily [<5 cigarettes per day], daily), and preferred language (English or Spanish) were associated with receiving clinician advice to quit and knowledge and use of tobacco treatment. We included an interaction between smoking status and language to test whether the relation between smoking status and key outcomes varied with preferred language. Overall, 80% of respondents received clinician advice to quit, 84% knew that KPNC offers cessation counseling, 54% knew that cessation pharmacotherapy is free, 54% used pharmacotherapy, and 6% used counseling. In multivariate models, Spanish-speaking light/nondaily smokers had significantly lower rates of all outcomes, while there was no association with other demographic and clinical characteristics. Following ACA implementation, most smokers newly enrolled in KPNC received clinician advice to quit and over half used pharmacotherapy, yet counseling utilization was low. Spanish-language outreach efforts and treatment services are recommended, particularly for adults who are light/nondaily smokers.
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Affiliation(s)
- Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Andy S L Tan
- Department of Social and Behavioral Health, Harvard T.H. Chan School of Public Health, Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alyce S Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Daniella Klebaner
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Cynthia I Campbell
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Judith J Prochaska
- Stanford Prevention Research Center, Stanford University, Stanford, CA, USA
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Castro Y, Bares CB, Castillo B, Kennedy A. Sociodemographics, but not Acculturation Proxies, Account for Differences in Lifetime Cessation between White and Hispanic Smokers. Ethn Dis 2018; 28:145-152. [PMID: 30038475 PMCID: PMC6051509 DOI: 10.18865/ed.28.3.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Prominent addiction theories predict that Hispanic smokers should have more success at quitting than White smokers due to less physical dependence on average, but extant findings are mixed. This might be due in part to a lack of attention to confounding demographic and acculturation-related variables. Our study compared likelihood of lifetime cessation between White and Hispanic men and women of different language proficiency, nativity and residency status, controlling for age, education, and poverty level. Method Data from 123,574 White and Hispanic participants in the 2011-2015 National Health Interview Surveys were used. Logistic regression analyses examined ethnic differences in odds of being a former smoker. Predicted probabilities of being a former smoker were calculated from these models. Results In unadjusted analyses, White men demonstrated higher odds of being a former smoker compared with Hispanic men, Hispanic women, and White women. In adjusted analyses, Hispanics demonstrated higher odds of being a former smoker compared with Whites, and differences by acculturation proxies emerged. Conclusions Not accounting for demographics may suppress ethnic differences in likelihood of smoking cessation. Among Hispanics, demographics may be more important determinants of lifetime quitting than acculturation-related characteristics.
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Affiliation(s)
- Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, Texas
| | | | | | - Ariel Kennedy
- School of Social Work, University of Michigan, Ann Arbor, Michigan
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Pinsker EA, Hennrikus DJ, Erickson DJ, Call KT, Forster JL, Okuyemi KS. Trends in self-efficacy to quit and smoking urges among homeless smokers participating in a smoking cessation RCT. Addict Behav 2018; 78:43-50. [PMID: 29125976 DOI: 10.1016/j.addbeh.2017.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In the U.S., approximately 73% of homeless adults smoke cigarettes and they experience difficulty quitting. Homeless smokers report low self-efficacy to quit and that smoking urges are a barrier to quitting. Self-efficacy to quit and smoking urges are dynamic and change throughout smoking cessation treatment. This study examines changes in self-efficacy to quit and smoking urges throughout a smoking cessation intervention among the homeless and identifies predictors of change in these characteristics. METHODS Homeless smokers (n=430) participating in a smoking cessation randomized controlled trial in the U.S. completed surveys at baseline, and weeks 1, 2, 4, 6, 8, and 26 on demographic and smoking characteristics (i.e., confidence to quit, self-efficacy to refrain from smoking, and smoking urges). A growth curve analysis was conducted by modeling change in the smoking characteristics over time and examining the variability in the change in smoking characteristics by demographic characteristics and treatment group. RESULTS Among the full sample, self-efficacy to refrain from smoking increased linearly over time, confidence to quit increased until the midpoint of treatment but subsequently decreased, and smoking urges decreased until the midpoint of treatment but subsequently increased. There were race differences in these trajectories. Racial minorities experienced significantly greater increases in self-efficacy to refrain from smoking than Whites and Blacks had higher confidence to quit than Whites. CONCLUSIONS White participants experienced less increase in self-efficacy to refrain from smoking and lower confidence to quit and therefore may be a good target for efforts to increase self-efficacy to quit as part of homeless-targeted smoking cessation interventions. Sustaining high confidence to quit and low smoking urges throughout treatment could be key to promoting higher cessation rates among the homeless.
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Valera P, McClernon FJ, Burkholder G, Mugavero MJ, Willig J, O'Cleirigh C, Cropsey KL. A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV. AIDS Behav 2017; 21:1975-1984. [PMID: 27942999 DOI: 10.1007/s10461-016-1634-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.
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Affiliation(s)
- Pamela Valera
- Division of Social Solutions and Services Research, The Nathan Kline Institute for Psychiatric Research and Department of Psychiatry, New York University School of Medicine, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Addiction Division, Duke University School of Medicine, 2628 Erwin Rd, Durham, NC, 27707, USA
| | - Greer Burkholder
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Michael J Mugavero
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - James Willig
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Behavioral Medicine, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA
| | - Karen L Cropsey
- Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, 1720 2nd Ave S., Birmingham, AL, 35294-0017, USA.
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Association of Weight Perception, Race and Readiness to Quit Smoking amongst a Cohort of Workers. J Smok Cessat 2016. [DOI: 10.1017/jsc.2016.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Weight concerns may inhibit smoking quit attempts and may be more influential amongst African-Americans who are more likely to be overweight.Aims: To assess if weight perception is associated with readiness to quit and whether this relationship is modified by race.Methods: We used data from a cohort of current smokers undergoing routine health examinations. Based on differences between ideal and measured BMI, participants’ weight perceptions were classified as within, somewhat above, or far above ideal weight. Logistic regression analysis was used to evaluate adjusted associations of weight perception and race with readiness to quit.Results: Of 2,831 current smokers, 23% were obese and 38% overweight. Amongst white smokers, those who perceived being far above ideal weight were more likely to be ready to quit (OR: 1.45, 95% CI: 1.03–2.03), but this association was not observed for African-American smokers who perceived themselves to be somewhat or far above their ideal weight (OR: 0.35, 95% CI: 0.10–1.24 and OR: 0.36, 95% CI: 0.11–1.19, respectively).Conclusions: Perception of being overweight is associated with increased readiness to quit amongst white but not African-American smokers. Smoking cessation programmes may need to culturally tailor interventions based on smokers’ weight perceptions.
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Bandiera FC, Assari S, Livaudais-Toman J, Pérez-Stable EJ. Latino and Black smokers in the Health and Retirement Study are more likely to quit: the role of light smoking. Tob Induc Dis 2016; 14:23. [PMID: 27436994 PMCID: PMC4950112 DOI: 10.1186/s12971-016-0090-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 07/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older persons are more vulnerable to tobacco mortality and less likely to make quit attempts. Less is known, however, about the role of race and ethnicity on quit rates in the U.S. Using a nationally representative data source of older adults in U.S., we aimed to study racial and ethnic differences in smoking cessation rates. METHODS We used data from all waves of the Health and Retirement Study (HRS) between 1992-2012. The HRS is a longitudinal nationally representative survey of adults over the age of 50 in the United States. We followed current smokers at baseline (year 1992) until time to first quit. Race/ethnicity was the main predictor; gender, age, education, marital status, count of chronic medical conditions, depressive symptoms, and drinking at baseline were control variables. Cox regression was used for analysis of time to quit. RESULTS Hazard ratios of quitting during the first ten (Hazard ratio = 1.51, p < 0.05) and 20 years (Hazard ratio = 1.46, p < 0.05) were larger for Latinos over the age of 50 compared to Whites. In addition, hazard ratios of quitting during the first 20 years (Hazard ratio = 1.19, p < 0.05) were larger for Blacks over the age of 50 compared to Whites. These findings were partially explained by cigarette consumption intensity, such that Latinos were lighter smokers and therefore more likely to quit than Whites. CONCLUSION Latinos and Blacks were more likely than Whites to quit smoking cigarettes within 20 years. However, this finding may be explained by cigarette consumption intensity.
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Affiliation(s)
- Frank C Bandiera
- University of Texas School of Public Health, Dallas Regional Campus, 6011 Harry Hines Blvd., V8.112, Dallas, TX 75390-9128 USA ; University of Texas Southwestern Harold C. Simmons Cancer Center, 6011 Harry Hines Blvd., V8.112, Dallas, TX 75390-9128 USA
| | - Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109 USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109 USA
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, University of California, 3333 California Street, San Francisco, CA 94143 USA
| | - Eliseo J Pérez-Stable
- National Institute of Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892-5465 USA
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Castro Y. Determinants of Smoking and Cessation Among Latinos: Challenges and Implications for Research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2016; 10:390-404. [PMID: 27672402 DOI: 10.1111/spc3.12256] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tobacco is a significant burden to individual and public health, and disparities exist among Latino smokers with respect to use and cessation. Although the prevalence of smoking is lower for Latinos than for non-Latino Whites and the general U.S. population, numerous health disparities exist within the population of Latino smokers. Much is known about determinants of smoking and cessation but the vast majority of this knowledge is based on research with non-Latino White smokers. This results in at least two important challenges in tobacco research among Latino smokers: (i) demonstrating the generalizability of known determinants of smoking and cessation, and; (ii) identifying culturally relevant variables that influence smoking and cessation among Latinos. An argument for increased research in these areas is presented with a review of existing research among Latino smokers that demonstrates these needs. Research is summarized that suggests socioeconomic position, depressive symptomatology, physical dependence, and gender function differently as determinants of smoking and cessation among Latinos compared with the general population of smokers. Research is also reviewed that suggests the promise of acculturation, acculturative stress, and discrimination as culturally relevant determinants of smoking and cessation. Research and practice implications are discussed, and specific areas for future research are offered.
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Kulak JA, Cornelius ME, Fong GT, Giovino GA. Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey. Nicotine Tob Res 2016; 18 Suppl 1:S79-87. [PMID: 26980868 PMCID: PMC5009448 DOI: 10.1093/ntr/ntv228] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/30/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION While cigarette smoking prevalence is declining among US adults, quit rates may differ between white and African American smokers. Here, we summarize the literature on smoking cessation behaviors in whites and African Americans across four study designs and report the findings of new analyses of International Tobacco Control (ITC) US Survey cohort data. METHODS We reviewed 32 publications containing 39 relevant analyses that compared quit attempts and abstinence between US whites and African Americans. Two additional longitudinal analyses were conducted on 821 white and 76 African American cigarette smokers from Waves 7 and 8 of the ITC US Survey (mean follow-up = 19 months). RESULTS Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community- and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. CONCLUSIONS Of 11 population- or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. IMPLICATIONS This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit further study.
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Affiliation(s)
- Jessica A Kulak
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY;
| | - Monica E Cornelius
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Browning KK, Wewers ME, Ferketich AK, Diaz P, Koletar SL, Reynolds NR. Adherence to Tobacco Dependence Treatment Among HIV-Infected Smokers. AIDS Behav 2016; 20:608-21. [PMID: 25855045 PMCID: PMC5257340 DOI: 10.1007/s10461-015-1059-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
High prevalence of tobacco use and low success in quitting remain significant problems for reducing disease burden among HIV-infected persons. This study's purpose was to examine participant responsiveness and tobacco dependence treatment adherence and their influences on tobacco abstinence among HIV-infected patients. This non-randomized study included HIV-infected smokers 18 years of age or older, who smoked at least 5 cigarettes per day, and had an interest in quitting smoking in the next 30 days. HIV-infected smokers (n = 247) received a 12-week tobacco dependence treatment intervention that included pharmacotherapy and telephone counseling. Younger age and non-White race were associated with lower adherence to pharmacotherapy. Younger age, non-White race, and increased monthly binge drinking were associated with lower adherence to telephone counseling. High participant responsiveness was associated with adherence to pharmacotherapy, counseling, and abstinence. Development and testing of interventions to improve adherence to evidence-based tobacco dependence treatment is warranted.
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Affiliation(s)
- Kristine K Browning
- College of Nursing, The Ohio State University and The Ohio State University Wexner Medical Center, 370 Newton Hall, 1585 Neil Avenue, Columbus, OH, 34210, USA.
| | - Mary Ellen Wewers
- Division of Health Behavior and Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Philip Diaz
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Susan L Koletar
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Burgess DJ, van Ryn M, Noorbaloochi S, Clothier B, Taylor BC, Sherman S, Joseph AM, Fu SS. Smoking cessation among African American and white smokers in the Veterans Affairs health care system. Am J Public Health 2014; 104 Suppl 4:S580-7. [PMID: 25100424 DOI: 10.2105/ajph.2014.302023] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether a proactive care smoking cessation intervention designed to overcome barriers to treatment would be especially effective at increasing cessation among African Americans receiving care in the Veterans Health Administration. METHODS We analyzed data from a randomized controlled trial, the Veterans Victory over Tobacco study, involving a population-based electronic registry of current smokers (702 African Americans, 1569 whites) and assessed 6-month prolonged smoking abstinence at 1 year via a follow-up survey of all current smokers. We also examined candidate risk adjustors for the race effect on smoking abstinence. RESULTS The interaction between patient race and intervention condition (proactive care vs. usual care) was not significant. Overall, African Americans had higher quit rates than Whites (13% vs. 9%; P < .006) regardless of condition. CONCLUSIONS African Americans quit at higher rates than Whites. These findings may be a result of the large number of veterans receiving smoking cessation services and the lack of racial differences in receipt of these services as well as racial differences in smoking history, self-efficacy, and motivation to quit that favor African Americans.
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Affiliation(s)
- Diana J Burgess
- Diana J. Burgess, Siamak Noorbaloochi, Barbara Clothier, Brent C. Taylor, and Steven S. Fu are with the Center for Chronic Disease Outcomes Research, a VA Health Services Research and Development Center of Innovation, Minneapolis VA Health Care System, Minneapolis, MN. Michelle van Ryn is with Health Services Research, Mayo Clinic College of Medicine, Rochester, MN. Scott Sherman is with VA New York, Harbor Healthcare System and the Department of Population Health, New York University School of Medicine, New York, NY. Anne M. Joseph is with the Department of Medicine, University of Minnesota Medical School, Minneapolis
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Weinberger AH, Pilver CE, Mazure CM, McKee SA. Stability of smoking status in the US population: a longitudinal investigation. Addiction 2014; 109:1541-53. [PMID: 24916157 PMCID: PMC4127136 DOI: 10.1111/add.12647] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/04/2013] [Accepted: 05/29/2014] [Indexed: 01/16/2023]
Abstract
AIMS To determine smoking transitions in a representative sample of US adults. DESIGN Longitudinal study using data from the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-02; wave 2, 2004-05). SETTING The general US adult population. PARTICIPANTS A total of 33 309 adults (53.6% female) classified as wave 1 current daily, current non-daily, former daily, former non-daily or never smokers. MEASUREMENTS Smoking transitions were determined from waves 1 and 2 data. FINDINGS Smoking status remained stable for the majority of current daily (79.8%), former daily (95.8%), former non-daily (96.3%) and never (97.1%) smokers. Among current non-daily smokers, 54.5% quit smoking while 22.5% increased to daily smoking. Current daily smokers who were older [30-44, odds ratio (OR) = 0.62; 95% confidence interval (CI) = 0.49-0.78; 45+, OR = 0.75; 95% CI = 0.61-0.93] and unmarried (OR = 0.80, 95% CI = 0.66-0.96) were less likely to report smoking cessation. Current daily smokers who were Hispanic (OR = 2.15, 95% CI = 1.65-2.81) and college educated (OR = 1.27, 95% CI = 1.05-1.53) were more likely to report smoking cessation. Relapse in former daily smokers was greater in women (OR = 1.44, 95% CI = 1.01-2.06) and lower in older adults (OR = 0.44; 95% CI = 0.27-0.74). Smoking initiation occurred less in women (OR = 0.65; 95% CI = 0.49-0.87) and Hispanic adults (OR = 0.57; 95% CI = 0.36-0.91) and more in unmarried adults (OR = 1.84; 95% CI = 1.37-2.47) and adults with less education (OR = 1.63; 95% CI = 1.09-2.44). CONCLUSIONS From 2001 to 2005, smoking status was extremely stable in the US population. Specific gender, race and educational groups need increased prevention and intervention efforts.
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Affiliation(s)
- Andrea H. Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT 06520 USA
| | - Corey E. Pilver
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT 06520 USA
| | - Carolyn M. Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT
| | - Sherry A. McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT 06520 USA
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Hendricks PS, Westmaas JL, Park VMT, Thorne CB, Wood SB, Baker MR, Lawler RM, Hooper MW, Delucchi KL, Hall SM. Smoking abstinence-related expectancies among American Indians, African Americans, and women: potential mechanisms of tobacco-related disparities. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 28:193-205. [PMID: 23528192 PMCID: PMC4103623 DOI: 10.1037/a0031938] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared with men, women were more likely to expect withdrawal effects and weight gain. These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations.
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Webb Hooper M, Baker EA, McNutt MD. Racial/Ethnic differences among smokers: revisited and expanded to help seekers. Nicotine Tob Res 2013; 16:621-5. [PMID: 24336396 DOI: 10.1093/ntr/ntt206] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Most research on racial/ethnic differences among smokers is outdated and does not focus on help seekers. The purpose of this study was to revisit racial/ethnic differences in variables related to cessation in a sample of smokers enrolled in a randomized trial. METHODS Adult smokers (N = 417; n = 126 White; n = 123 Hispanic; n = 168 Black) completed measures of demographics, smoking history, alcohol use, depressive symptoms, and readiness to quit. RESULTS We found significant differences in these factors across groups. Blacks were more likely to be older, less educated, single, low income, smoke menthol cigarettes, and report greater nicotine dependence. Hispanics were younger, reported fewer years smoking and cigarettes per day, lower nicotine dependence, preferred mentholated cigarettes, and reported greater alcohol use intensity. After controlling for demographics and smoking history, Blacks reported greater depressive symptoms and lower readiness to quit compared with Whites and Hispanics. CONCLUSIONS Help-seeking Blacks may exhibit more risk factors for difficulty quitting compared with other groups. Hispanics may have some protective factors, such as lower dependence, but require attention to alcohol use and menthol smoking. Identifying preintervention racial/ethnic differences in characteristics related to cessation is important for developing evidence-based and culturally specific interventions and for reducing tobacco-related health disparities.
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Affiliation(s)
- Monica Webb Hooper
- Department of Psychology, Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL
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21
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Weinberger AH, Mazure CM, Morlett A, McKee SA. Two decades of smoking cessation treatment research on smokers with depression: 1990-2010. Nicotine Tob Res 2013; 15:1014-31. [PMID: 23100459 PMCID: PMC3693502 DOI: 10.1093/ntr/nts213] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 08/22/2012] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Adults with depression smoke at higher rates than other adults leaving a large segment of this population, who already incur increased health-related risks, vulnerable to the enormous harmful consequences of smoking. Yet, the impact that depression has on smoking cessation is not clear due to the mixed results of past research. The primary aims of this review were to synthesize the research examining the relationship of depression to smoking cessation outcomes over a 20-year period, to examine the gender and racial composition of these studies, and to identify directions for future research. METHODS Potential articles published between January 1, 1990 and December 31, 2010 were identified through a MEDLINE search of the terms "clinical trial," "depression," and "smoking cessation." 68 studies used all three terms and met the inclusion criteria. RESULTS The majority of studies examined either a past diagnosis of major depression or current depression symptoms. Within the few studies that examined the interaction of gender and depression on smoking cessation, depression had a greater impact on treatment outcomes for women than men. No study reported examining the interactive impact of race and depression on treatment outcomes. CONCLUSIONS Although attention to the relationship of depression and smoking cessation outcomes has increased over the past 20 years, little information exists to inform a treatment approach for smokers with Current Major Depressive Disorder, Dysthymia, and Minor Depression and few studies report gender and racial differences in the relationship of depression and smoking cessation outcomes, thus suggesting major areas for targeted research.
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Affiliation(s)
- Andrea H Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
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Castro Y, Businelle MS, Correa-Fernández V, Kendzor DE, Mazas CA, Cofta-Woerpel L, Wetter DW. Associations between indicators of acculturation and tobacco dependence among Spanish-speaking Latino smokers. Addict Behav 2012; 37:1101-8. [PMID: 22688345 DOI: 10.1016/j.addbeh.2012.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 03/26/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
The current study utilized regression analyses to explore the relationships among demographic and linguistic indicators of acculturation, gender, and tobacco dependence among Spanish-speaking Latino smokers in treatment. Additionally, bootstrapping analyses were used to examine the role of dependence as a mediator of the relationship between indicators of acculturation and cessation. Indicators of time spent in the United States were related to indicators of physical dependence. Preferred media language was related to a multidimensional measure of dependence. Gender did not impact the relationships between acculturation indicators and dependence. A multidimensional measure of dependence significantly mediated the relationship between preferred media language and cessation. Future research would benefit from consideration of acculturation and multidimensional measures of dependence when studying smoking cessation among Latinos, and from further examination of factors accounting for relationships among acculturation, dependence, and cessation.
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Simmons VN, Quinn G, Litvin EB, Rojas A, Jimenez J, Castro E, Meade CD, Brandon TH. Transcreation of validated smoking relapse-prevention booklets for use with Hispanic populations. J Health Care Poor Underserved 2011; 22:886-93. [PMID: 21841285 PMCID: PMC3804252 DOI: 10.1353/hpu.2011.0091] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This report describes the steps taken to develop an evidence-based series of current smoking relapse-prevention booklets for Hispanic smokers.
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Affiliation(s)
- Vani N Simmons
- Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33617, USA.
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Fucito LM, Juliano LM, Toll BA. Cognitive reappraisal and expressive suppression emotion regulation strategies in cigarette smokers. Nicotine Tob Res 2010; 12:1156-61. [PMID: 20829326 DOI: 10.1093/ntr/ntq146] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Negative affect is an important psychological factor in the promotion and maintenance of cigarette smoking, though the underlying factors that account for this relationship remain to be determined. One possible mechanism may be smokers' emotion regulation strategies. Preliminary research among adolescents and young adults suggests that greater utilization of expressive suppression versus cognitive reappraisal is associated with higher rates of smoking initiation. There is limited research, however, on the role of emotion regulation strategies in smoking maintenance in adult smokers. METHODS Data from participants in a laboratory study (N = 121) were used to examine whether utilization of cognitive reappraisal and/or expressive suppression were related to smoking characteristics and subjective (i.e., mood, urge to smoke ratings) and behavioral reactions (i.e., Emotional Stroop Task performance, smoking behavior) to a mood induction procedure. Data were evaluated for the full sample and subsample who endorsed current depressive symptoms (n = 46). RESULTS Frequent reappraisal was associated with weaker expectancies that smoking alleviates unpleasant feelings, greater positive mood, and fewer depressive symptoms. In contrast, frequent suppression was related to longer smoking history and greater attentional bias to smoking cues on an Emotional Stroop Task. Among the depressed subsample, reappraisal moderated the effect of mood condition on smoking duration, number of cigarette puffs, and carbon monoxide boost. CONCLUSIONS These results provide preliminary support that emotion regulation strategies may be associated with motivational correlates of smoking as well as actual smoking behavior among depressed smokers.
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Affiliation(s)
- Lisa M Fucito
- Department of Psychiatry, Yale University School of Medicine, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA.
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Duffy SA, Scheumann AL, Fowler KE, Darling-Fisher C, Terrell JE. Perceived difficulty quitting predicts enrollment in a smoking-cessation program for patients with head and neck cancer. Oncol Nurs Forum 2010; 37:349-56. [PMID: 20439219 DOI: 10.1188/10.onf.349-356] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. DESIGN This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention. SETTING Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. SAMPLE 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. METHODS Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers' participation in an intervention study. MAIN RESEARCH VARIABLES Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. FINDINGS Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. CONCLUSIONS Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. IMPLICATIONS FOR NURSING Oncology nurses are in an opportune position to assess patients' perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population.
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Affiliation(s)
- Sonia A Duffy
- School of Nursing, Department of Otolaryngology, and Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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Castro Y, Reitzel LR, Businelle MS, Kendzor DE, Mazas CA, Li Y, Cofta-Woerpel L, Wetter DW. Acculturation differentially predicts smoking cessation among Latino men and women. Cancer Epidemiol Biomarkers Prev 2010; 18:3468-75. [PMID: 19959697 DOI: 10.1158/1055-9965.epi-09-0450] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The current study examined the influence of gender, acculturation indicators, and their interaction on smoking cessation among Latinos. METHODS Logistic regression analysis was used to examine the main effects of gender, acculturation indicators, and their interactions on self-reported 7-day abstinence at 12-week follow-up among 271 Latino smokers seeking cessation counseling. RESULTS Analyses revealed significant main effects for several acculturation indicators and significant interactions of gender with number of years lived in the United States, proportion of life lived in the United States, and preferred media language (all P values <0.05). Follow-up analyses indicated no significant relationships between abstinence and acculturation indicators among women. Among men, abstinence rates increased with years in the United States, proportion of life in the United States, and preferred media language of English. CONCLUSIONS Greater acculturation predicted higher abstinence rates, but this relationship was restricted to men. This study is among the first to examine the effects of gender and acculturation on smoking abstinence among Latinos. Findings highlight the need for research focused on mechanisms underlying these relationships.
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Affiliation(s)
- Yessenia Castro
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, 77230-1402, USA.
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Lloyd-Richardson EE, Stanton CA, Papandonatos GD, Shadel WG, Stein M, Tashima K, Flanigan T, Morrow K, Neighbors C, Niaura R. Motivation and patch treatment for HIV+ smokers: a randomized controlled trial. Addiction 2009; 104:1891-900. [PMID: 19719796 PMCID: PMC2763031 DOI: 10.1111/j.1360-0443.2009.02623.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIMS To test the efficacy of two smoking cessation interventions in a HIV positive (HIV+) sample: standard care (SC) treatment plus nicotine replacement therapy (NRT) versus more intensive motivationally enhanced (ME) treatment plus NRT. DESIGN Randomized controlled trial. SETTING HIV+ smoker referrals from eight immunology clinics in the northeastern United States. PARTICIPANTS A total of 444 participants enrolled in the study (mean age = 42.07 years; 63.28% male; 51.80% European American; mean cigarettes/day = 18.27). INTERVENTIONS SC participants received two brief sessions with a health educator. Those setting a quit date received self-help quitting materials and NRT. ME participants received four sessions of motivational counseling and a quit-day counseling call. All ME intervention materials were tailored to the needs of HIV+ individuals. MEASUREMENTS Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups. FINDINGS Intent-to-treat (ITT) abstinence rates at 2-month, 4-month and 6-month follow-ups were 12%, 9% and 9%, respectively, in the ME condition, and 13%, 10% and 10%, respectively, in the SC condition, indicating no between-group differences. Among 412 participants with treatment utilization data, 6-month ITT abstinence rates were associated positively with low nicotine dependence (P = 0.02), high motivation to quit (P = 0.04) and Hispanic American race/ethnicity (P = 0.02). Adjusting for these variables, each additional NRT contact improved the odds of smoking abstinence by a third (odds ratio = 1.32, 95% confidence interval = 0.99-1.75). CONCLUSIONS Motivationally enhanced treatment plus NRT did not improve cessation rates over and above standard care treatment plus NRT in this HIV+ sample of smokers. Providers offering brief support and encouraging use of nicotine replacement may be able to help HIV+ patients to quit smoking.
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Affiliation(s)
- Elizabeth E. Lloyd-Richardson
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island,Department of Psychology, University of Massachusetts Dartmouth
| | - Cassandra A. Stanton
- The Warren Alpert Medical School of Brown University, Transdisciplinary Research Group, Butler Hospital, Providence, Rhode Island
| | | | | | - Michael Stein
- The Warren Alpert Medical School of Brown University, Transdisciplinary Research Group, Butler Hospital, Providence, Rhode Island
| | - Karen Tashima
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Timothy Flanigan
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kathleen Morrow
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Charles Neighbors
- Columbia University, Center on Addiction and Substance Abuse, New York, New York
| | - Raymond Niaura
- The Warren Alpert Medical School of Brown University, Transdisciplinary Research Group, Butler Hospital, Providence, Rhode Island
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Levine MD, Marcus MD, Leon-Verdin M. Similarities in affect, perceived stress, and weight concerns between Black and White women who quit smoking during pregnancy. Nicotine Tob Res 2008; 10:1543-8. [PMID: 18946773 DOI: 10.1080/14622200802323290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mood and weight concerns may relate to postpartum smoking, and racial differences in these concerns may be important in developing interventions to prevent postpartum relapse. We compared differences in the smoking patterns, mood, and weight concerns of Black and White women who quit smoking during pregnancy (N = 174). In univariate comparisons, there were no consistent differences in nicotine dependence, smoking history, or motivation to remain abstinent postpartum. Moreover, although there were univariate differences in negative affect, smoking for weight control, and eating disinhibition, after controlling for differences in income and educational background between Black and White women, these differences in mood and weight concerns were no longer significant. In our sample of pregnant women who had quit smoking, Black and White women did not differ in mood and weight concerns, two potentially modifiable variables that may affect smoking postpartum relapse.
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Affiliation(s)
- Michele D Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Sias JJ, Urquidi UJ, Bristow ZM, Rodriguez JC, Ortiz M. Evaluation of smoking cessation behaviors and interventions among Latino smokers at low-income clinics in a US-Mexico border county. Addict Behav 2008; 33:373-80. [PMID: 18006240 DOI: 10.1016/j.addbeh.2007.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2006] [Revised: 09/05/2007] [Accepted: 09/20/2007] [Indexed: 10/22/2022]
Abstract
A descriptive study of 94 Latino smokers receiving nicotine replacement therapy (NRT) in US-Mexico border clinics in El Paso County, Texas was conducted. A baseline questionnaire and two follow-up telephone surveys (8-12 weeks and 6 months) were administered to evaluate smoking habits, behaviors, and cessation interventions. Participants reported an average daily cigarette consumption of 15 cigarettes and smoked within 30 min of waking (44%). Primary motivations for quitting were personal health (95%), family's health (74%), and doctor's advice (71%). Female smokers were more likely to smoke due to being anxious (p=0.012), not being able to sleep (p=0.02), or to feel thin (p=0.002). Male smokers were more likely to smoke when drinking alcohol (p=0.005). Nearly 40% of smokers reported they had never tried to quit before. Medication use at baseline was 82% patch, 53% lozenge, 29% gum, and 24% bupropion (combination therapy permitted). At 8-12 weeks, nearly two-thirds of patients were quit and 44% remained quit at six months. Smoking habits, behaviors, and successful cessation interventions among Latinos in a US-Mexico border community were identified.
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Lloyd-Richardson EE, Stanton CA, Papandonatos GD, Betancourt RM, Stein M, Tashima K, Morrow K, Niaura R. HIV-positive smokers considering quitting: differences by race/ethnicity. Am J Health Behav 2008; 32:3-15. [PMID: 18021029 PMCID: PMC2538375 DOI: 10.5555/ajhb.2008.32.1.3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
OBJECTIVE To better characterize smoking in HIV-positive individuals and to identify critical components of a targeted smoking cessation intervention for multiethnic HIV-positive smokers. METHODS Differences in baseline characteristics of 444 HIV-positive smokers were examined by race, and a multivariate linear regression model evaluated factors associated with nicotine dependence in an HIV-positive population, with a particular emphasis on race/ethnic differences. RESULTS Low smoking self-efficacy and higher contemplation of quitting were predictive of greater nicotine dependence. An interaction between age and race was noted, with older Hispanic Americans less likely to be nicotine dependent. CONCLUSIONS Efforts should be made to tailor smoking cessation intervention content to HIV-positive racial/ethnic minority groups.
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Affiliation(s)
- Elizabeth E Lloyd-Richardson
- Brown Medical School, The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI 02903, USA.
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Li MD, Payne TJ, Ma JZ, Lou XY, Zhang D, Dupont RT, Crews KM, Somes G, Williams NJ, Elston RC. A genomewide search finds major susceptibility loci for nicotine dependence on chromosome 10 in African Americans. Am J Hum Genet 2006; 79:745-51. [PMID: 16960812 PMCID: PMC1592559 DOI: 10.1086/508208] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Accepted: 07/28/2006] [Indexed: 12/11/2022] Open
Abstract
Epidemiological studies have demonstrated that genetic factors account for at least 50% of the liability for nicotine dependence (ND). Although several linkage studies have been conducted, all samples to date were primarily of European origin. In this study, we conducted a genomewide scan of 1,261 individuals, representing 402 nuclear families, of African American (AA) origin. We examined 385 autosomal microsatellite markers for ND, which was assessed by smoking quantity (SQ), the Heaviness of Smoking Index (HSI), and the Fagerstrom Test for ND (FTND). After performing linkage analyses using various methods implemented in the GENEHUNTER and S.A.G.E. programs, we found a region near marker D10S1432 on chromosome 10q22 that showed a significant linkage to indexed SQ, with a maximum LOD score of 4.17 at 92 cM and suggestive linkage to HSI, SQ, and log-transformed SQ. Additionally, we identified three regions that met the criteria for suggestive linkage to at least one ND measure: on chromosomes 9q31 at marker D9S1825, 11p11 between markers D11S1993 and D11S1344, and 13q13 between markers D13S325 and D13S788. Other locations on chromosomes 15p11, 17q25, and 18q12 exhibited some evidence of linkage for ND (LOD >1.44). The four regions with significant or suggestive linkage were positive for multiple ND measures by multiple statistical methods. Some of these regions have been linked to smoking behavior at nominally significant levels in other studies, which provides independent replication of the regions for ND in different cohorts. In summary, we found significant linkage on chromosome 10q22 and suggestive linkage on chromosomes 9, 11, and 13 for major genetic determinants of ND in an AA sample. Further analysis of these positive regions by fine mapping and/or association analysis is thus warranted. To our knowledge, this study represents the first genomewide linkage scan of ND in an AA sample.
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Affiliation(s)
- Ming D Li
- Department of Psychiatric Medicine, University of Virginia, Charlottesville, VA 22911, USA.
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